Can the nearly 12 million Americans who take cholesterol-lowering drugs save money by splitting high-dose pills in half, and get the same results as if they were taking lower-dose pills?
Yes, according to a study to be released later this month by University of Michigan researchers.
The study found that splitting the cholesterol-lowering pills in half is safe and effective and saved patients an average of $5 to $7 in monthly co-pays.
Although the savings may seem insignificant, most patients want to save a few dollars where they can, said lead author Hae Mi Choe, a clinical assistant professor in the university's College of Pharmacy and a U-M Health System clinical pharmacist. The research will be published in the American Journal of Managed Care.
Susan Blackwell, a U-M employee who participated in the six-month study, pays $8 a month for Simvastatin, the generic version of the cholesterol-lowering drug Zocor. She was not aware before the study that she could split her tablets; now she plans to start. Pill-splitting would reduce her co-pay to $4 a month.
"Nowadays, any time you can save money, it helps," she said Tuesday. "You have a little more to put in the gas tank."
The primary objective of the U-M study was to test whether giving patients a financial incentive would affect their decision to split pills, Choe said.
By the end of the study, most participants said they would continue splitting pills if they received a co-pay reduction of at least 50%.
As a result of the 2005 research, in 2006 U-M started a pill-splitting program that saved the university $195,000 and cut drug costs for 500 employees and retirees by more than $25,000.
A common practice
Patients have been splitting cholesterol-lowering pills for years to save money. High-dose pills often cost the same as lower-dose pills -- or just slightly more. Cutting the pills and taking half doses reduces patients' out-of-pocket prescription costs. For example, a patient might pay $116 for 30 tablets of 20-mg Lipitor, versus $58 for 15 of the 40-mg tablets that can be split to double the number of doses. Both supplies last 30 days.
Rebecca Hamm, a spokeswoman for Pfizer Inc., which manufactures Lipitor, said the company does not recommend splitting the tablet because it was not designed to be cut, and patients could end up ingesting a different dosage than what was approved.
"Lipitor tablets are not scored," she said. "Since splitting means it would be a different dosage than what is approved by the FDA, we just don't recommend that people do it because you could end up with a different dosage or a crumbled tablet."
But splitting cholesterol-lowering pills is a safe practice, according to doctors and pharmacists, because small day-to-day dose fluctuations that can occur when cut pills are taken do not make a major difference in cholesterol levels.
Pills can be split as long as they are not coated or time-release tablets, said pharmacist Melinda Zaher, who co-owns Crown Pharmacy in Redford Township.
Because cholesterol-lowering drugs are not long-acting or coated, they can be split and still have the same effects as taking a whole pill, Zaher said.
"Every single strength of those drugs costs the same amount, so if we can help save the client money, we do so by splitting the pill."
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